Last updated on March 2019

Comparison of 2 Strategies of Adjustment of Mechanical Ventilation in Patients With Acute Respiratory Distress Syndrome


Brief description of study

The aim of this multicenter randomized controlled trial is to compare the impact on mortality of patients mechanically ventilated for acute lung injury or acute respiratory distress syndrome of two strategies for setting end-expiratory pressure.

Detailed Study Description

Most patients suffering from acute lung injury or acute respiratory distress syndrome require mechanical ventilation. In this setting, positive end-expiratory pressure is used to improve arterial oxygenation. While the beneficial effect on clinical outcome of using low tidal volume is clearly proven, the best way to titrate PEEP is not known. Higher PEEP levels may better improve oxygenation and reduce ventilator-induced lung injury by reducing end-expiratory alveolar collapse but may also cause circulatory depression and aggravate lung injury from end-inspiratory overdistension. This trial compares the impact on outcome of two strategies for setting PEEP. In the "minimal alveolar distension" arm, PEEP is set for a total PEEP (PEEP + intrinsic PEEP) between 5 and 9 cm H20). In the "maximal alveolar recruitment" arm, PEEP is set for a plateau pressure between 28 and 30 cm H20. A tidal volume of 6 ml/kg predicted body weight is used in the two arms. The goals for arterial oxygenation and PaCO2 are the same in the two arms.

Clinical Study Identifier: NCT00188058

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General Hospital of Aix en Provence

Aix-en-Provence, France

Victor Dupouy Hospital

Argenteuil, France

Robert Ballanger Hospital

Aulnay-sous-Bois, France

General Hospital of Avignon

Avignon, France

Hospital of Beauvais

Beauvais, France

Saint Andr Hospital

Bordeaux, France

Cavale Blanche Hospital

Brest, France

Hospital of Brive

Brive, France

Henri Mondor Hospital

Creteil, France

Henri Mondor Hospital

Créteil, France

Hospital of Dax

Dax, France

Hospital of Dieppe

Dieppe, France

Departemental Hospital

La Roche-sur-Yon, France

Jacques Monod Hospital

Le Havre, France

Le Kremlin Bicetre Hospital

Le Kremlin-Bicetre, France

Croix Rousse Hospital

Lyon, France

Bon Secours Hospital

Metz, France

Saint Eloi Hospital

Montpellier, France

Hospital of Nancy

Nancy, France

Oloron Sainte Marie Hospital

Oloron-Sainte-Marie, France

Ren Dubos Hospital

Pontoise, France

Charles Nicolle Hospital

Rouen, France

Saint Aubin Les Elbeuf Hospital

Saint-Aubin-les-Elbeuf, France

University Hospital of Bellevue

Saint-Etienne, France

Hospital of Soissons

Soissons, France

Hautepierre Hospital

Strasbourg, France

Gustave Dron Hospital

Tourcoing, France

Recruitment Status: Closed


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